| NPI | 1972749133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AR P2311011) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AR 419-L) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2023-12-14 |